Women's Urologic Health
UK HealthCare Urological Surgery provides specialized care for women by offering state-of-the-art evaluation and treatment of female urologic problems. Deborah Erickson, MD and Katie Ballert, MD have special expertise in female urologic disorders such as urinary incontinence, pelvic organ prolapse, vaginal fistula, urethral diverticulum, urinary tract infections, and interstitial cystitis. While these problems are common in women, we also offer specialized treatment to men with symptoms of incontinence, difficulty urinating or interstitial cystitis.
Urinary incontinence is the inability to hold urine. There are several possible causes and several different types of urinary incontinence, including:
- Stress incontinence (loss of urine with activities such as coughing or lifting).
- Urge incontinence (when the person feels the urge to urinate, the urine comes out too quickly, before the person can get to the bathroom).
- Mixed incontinence (a person has both stress and urge incontinence).
- Total incontinence (leaking urine all the time, regardless of activity or urge sensations).
- Overflow incontinence (leaking urine because the bladder stays full all the time, and urine leaks out from the full bladder).
Figuring out the type and cause of incontinence may be straightforward or require specialized tests such as urodynamics, cystoscopy and X-ray testing. These specialized tests are part of the expertise provided by UK HealthCare Urological Surgery.
Treatment options depend on the type and cause of incontinence, and may include pelvic muscle exercises, medications or surgery. Dr. Erickson and Dr. Ballert have special expertise in surgical treatments for incontinence.
Pelvic organ prolapse
Due to a lack of support, pelvic structures may drop from their natural positions into or even outside of the vaginal canal. Several structures can be involved including the bladder, uterus, small bowel, rectum and/or the vaginal wall. Several factors may contribute to the development of pelvic organ prolapse including: pregnancy, childbirth, prior surgery, obesity, chronic coughing or constipation. Pelvic organ prolapse may or may not be symptomatic. Symptoms may include: a vaginal bulge or pressure, frequent or urgent urination, urinary incontinence, or bowel symptoms. Treatment options include using a pessary (a device inserted into the vagina that supports the pelvic structures) or surgical correction. Dr. Ballert has special expertise in surgical treatments for pelvic organ prolapse. .
A vaginal fistula is a hole between the bladder and the vagina which may develop after pelvic surgery, a difficult vaginal delivery or radiation treatments. Incontinence occurs because urine leaks from the bladder into the vagina and then out the vagina. The only treatment is surgery. Dr. Erickson and Dr. Ballert have special expertise in this type of surgery.
A urethral diverticulum is a pocket that bulges out from the urethra (urine channel). In come cases, it does not cause any symptoms or problems and does not need to be treated. However, the condition should be re-examined at intervals because there is a small risk of developing cancer in the pocket. Most patients with a diverticulum do have symptoms such as incontinence, pain with sexual intercourse and/or frequent urinary tract infections. Some patients can feel the pocket as a lump in the front wall of the vagina. Surgery is the only way to treat a urethral diverticulum. Dr. Erickson and Dr. Ballert have special expertise in this type of surgery.
Urinary tract infections
Most women get at least one urinary tract infection at some point in their lives. Single or occasional urinary tract infections are usually treated with antibiotics prescribed by primary care providers. Patients with frequent infections, or who do not improve with antibiotics, are often sent for urologic evaluation.
There are several different causes for frequent or persistent infection symptoms. Evaluation depends on the clinical situation and may include X-ray testing, urodynamics and/or cystoscopy. Treatments options also vary, depending on evaluation results. This specialized evaluation and treatment are part of the expertise provided by UK HealthCare Urological Surgery.
Interstitial cystitis (IC) is a chronic (ongoing) disorder characterized by an inflamed or irritated bladder. The cause of IC is currently unknown. Typical symptoms include:
- Pelvic pain that increases when the bladder gets full.
- Frequent urination because the full bladder is so painful.
- Getting up at night to urinate because the full bladder is so painful.
- Certain foods or drinks may make the symptoms worse.
- Symptoms may be worse a few days before having a menstrual period.
There is no exact test to diagnose IC, so the diagnosis is made based on symptoms, physical exam, urinalysis, urine culture, other testing as needed and clinical judgment. In some cases, it is fairly straightforward to diagnose and treat IC. While there is currently no “cure” for IC, most patients can be at least partially improved with treatment. However, in some cases IC can be very difficult to diagnose and/or treat for several possible reasons:
- Other medical problems may cause symptoms similar to IC symptoms.
- Some IC patients do not have the typical symptoms.
- Conditions such as fibromyalgia, endometriosis or vulvodynia in addition to IC can also cause pain.
- Several different treatments are available and there is no way to predict ahead of time which treatment will work best for any individual patient.
UK HealthCare Urological Surgery offers special expertise in diagnosing and treating IC. Many different treatments options are used including oral medications, medications placed into the bladder, diet changes, physical therapy and, in selected cases, surgery. Depending on the individual patient’s clinical situation, the treatment plan may involve collaboration with other specialties in addition to urology.